Anthrax - From Russia with Love

Michael C. Fishbein, MD

Dr. Fishbein received his undergraduate and medical degrees from the University of Illinois. He completed a residency in anatomic and clinical pathology at Harbor General Hospital/UCLA Medical Center. He is board certified in anatomic and clinical pathology.

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Editor's note: the following article was developed from a lecture given by Dr. David Walker in 1994. It is a disconcerting account of how the worst recorded outbreak of anthrax, a disease caused by
Bacillus anthracsis bacteria, was handled in Russia in 1979. Dr. Walker (currently a Professor of Pathology and Chairman of the Department of Pathology at the University of Texas Medical Branch (UTMB) was intimately involved in the studies that were done after the outbreak. There is a short addendum at the end of this article.

This article recounts the chilling, yet fascinating story of the deadliest outbreak of anthrax in recorded history. Anthrax is a bacterium (germ) that can cause a serious, sometimes fatal infection. Anthrax can be used as a weapon. In 2001, anthrax was spread through the mail in a powder. Twenty-two people were infected. The events that occurred in Sverdlovsk, Russia, in 1979 demonstrate what can happen when anthrax is released into the air.

The Outbreak

This was the ninth day of the mysterious, fatal epidemic that
struck Sverdlovsk in early April of 1979. Autopsies already had been performed
on 37 victims who died of an unknown disease. Yet neither the clinicians nor the
pathologists had identified the cause of the epidemic. Moreover, as you can
imagine, the members of the pathology
department were frustrated and overburdened with work. So, on this day, Dr.
Faina Abramova, who had been chief of pathology at hospital #40, returned from retirement to help perform the
autopsies.

The first autopsy Dr. Abramova performed was number 38 of the 42 ultimately
performed by the local pathologists. The patient was a 43-year-old man who had
had weakness and fever for two days. He was admitted to the hospital where he
died four days later.